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Using Community Stakeholder Leverage to Supercharge Transformation

Board collaboration

As both an avid muscle car fanatic and a small-scale real estate investor, the terms “supercharge” and “leverage” have special places in my heart. A supercharger on an internal combustion engine forces more air into the combustion chamber (boost) to allow the generation of significantly more power compared to naturally aspirated engines. More power is the stuff dreams are made of for those with the proclivity for tire-shredding muscle cars (think about Tim Allen in the show “Home Improvement” who was always look for more power – even in his lawn mowers)!

Likewise, leverage in real estate investing and in the quality improvement arena is the concept of using other people’s money and/or actions to supplement your own money and/or actions to achieve enhanced results. Using leverage in real estate has allowed me to acquire assets at a level far beyond what would have been possible using 100 percent of my own capital. Thus, the similarity in the two related terms is exponentially enhanced results.

Now that I have your attention, let me give you an example of how we are trying to exponentially enhance our transformation efforts in Nevada. During the past several years, Nevada has seen a significant increase in Medicare fee-for-service hospital admissions and 30-day readmissions. This increase is in marked contrast to the rest of the country, where most states and communities are seeing reduced rates of hospital admissions and readmissions. In addition, the absolute rates of admissions and readmissions places Nevada in the bottom quartile of performance. Bottom line, Nevada has a high rate of Medicare fee-for-service hospital admissions and readmissions and the rate is getting even higher. We are a true national outlier and something unique is going on within our state. The statistician types like to call this special cause variation!

We here at HealthInsight (and with our community partners) have thrown everything but the kitchen sink at our eye-opening trend since 2014. However, thus far we have not been successful in reversing the trend or even slowing its acceleration. We have also talked to a plethora of community leaders, experts and others to try and discover the “root causes” of the increases in hospital admissions and readmissions. Again, to no real avail thus far. There have been some theories put forward but most folks we talk to throw up their hands and say they do not know. So, what is one to do?

Well, we have decided it is time to try supercharging our Nevada Community Board of Directors. Historically, board members attended quarterly meetings and heard updates on our projects, and contributed ideas and thoughts. We (including our board members) have decided it is time to roll up our sleeves and dig deeper into the community challenge of high hospital admission and readmission rates. The board will now focus on hospital readmissions for at least the next year. We have scheduled a July 19 board meeting to review the current state of 30-day readmissions in Nevada, discuss and assimilate current best practices for high-performing communities, and develop an action plan of how our board can serve as supercharged leverage to help us understand the problem and ultimately transform the Nevada health care system, ultimately reducing hospital readmissions.

We understand one meeting will not be the magic bullet in solving this complex community problem but having our board members more activated and leveraging their relationships with community stakeholders is a step in the right direction. I will provide updates in future blogs.

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